Surgical stapling devices for performing gastrointestinal surgery are known. Generally, these devices are categorized by their method of use and application. One type of device is designed for use under open surgery conditions, while a second type of device is designed for use in laparoscopic or endoscopic surgery. Included in the latter is the surgical method known as hand-assisted laparoscopic surgery (HALS).
HALS is a bridge method between open and laparoscopic surgical methods. In HALS, a special hand port is installed through a small (4–6 cm.) incision in the body. The hand port enables the surgeon to insert one hand into the abdominal cavity to assist with the laparoscopic procedure thereby retaining finger sensitivity which is lost in full laparoscopic procedures. HALS also enables the surgeon to insert hand operated palm size instruments through the hand port.
Prior art open and laparoscopic surgical devices are based on a plurality of mechanisms. Each device includes one or more specific improvements, such as means for reducing the risk of using the device when the staple cartridge is empty. These open and laparoscopic surgical devices include instruments which may be mechanically, gas or electrically driven.
Prior art laparoscopic instruments are generally similar to open surgery devices. However, they typically have an extended or elongated body with a pair of jaws connected to the distal end of the elongated portion. These jaws are pivotally mounted at the device's distal end for movement toward and away from each other while gripping body tissue. Many variations of this basic design exist with each device providing specific added features, such as articulation of the distal operating mechanism. As with open surgery devices, these instruments may be driven by various types of motive power sources.
As noted above, surgical instruments for the surgical stapling and excising of tissue are well known in the art. These include, for example, U.S. Pat. No. 4,520,817 to Green; U.S. Pat. No. 4,633,861 to Chow, et al.; U.S. Pat. No. 4,633,874 to Chow, et al.; U.S. Pat. No. 4,892,244 to Fox, et al.; U.S. Pat. No. 5,065,929 to Schulze, et al.; and U.S. Pat. No. 5,275,323 to Schulze, et al.
Laparoscopic and endoscopic devices are disclosed in a number of patents. These include inter alia U.S. Pat. No. 5,071,430 to de Salis, et al.; U.S. Pat. No. 5,040,715 to Green, et al.; U.S. Pat. Nos. 5,318,221, 5,413,268, 5,425,745 and 5,476,206, to Green, et al.; U.S. Pat. No. 5,326,013 to Green, et al.; U.S. Pat. No. 5,364,001 to Bryan; U.S. Pat. No. 5,456,401 to Green, et al.; U.S. Pat. Nos. 5,397,046 and 5,472,132 to Savage, et al.; U.S. Pat. No. 5,482,197 to Green, et al.; U.S. Pat. No. 6,250,532 to Green, et al.; U.S. Pat. No. 5,487,499 to Sorrentino, et al.; U.S. Pat. Nos. 5,476,206 and 5,431,322 to Green, et al.; U.S. Pat. Nos. 5,507,426 and 5,657,921 to Young, et al.; U.S. Pat. No. 6,010,054 to Johnson, et al.; U.S. Pat. No. 6,045,560 to McKean, et al.; U.S. Pat. No. 6,264,087 to Whitman; U.S. Pat. No. 6,505,768 to Whitman; U.S. Pat. No. 6,517,565 to Whitman, et al.; U.S. Pat. No. 6,315,184 to Whitman; U.S. Pat. No. 6,443,973 to Whitman; and U.S. Pat. No. 6,488,196 to Fenton, Jr.
The above-mentioned prior art devices provide a wide range of apparatuses and techniques for stapling, cutting, and excising tissue, typically a portion of the bowel. Generally, these devices require the surgeon to use both hands. In addition, as noted, the laparoscopic devices discussed in the above patents generally have elongated elements for entry into the body cavity while being actuated by the operator outside the cavity.
There appears to be a lack of compact simple devices for single-hand use where the device can be positioned and actuated totally within the abdominal cavity. Such a device is essential for use in HALS. Additionally, there does not appear to be a simple single-hand use device which allows for interrupting the stapling, and optionally the cutting, operation, repositioning the tissue being stapled, and optionally cut, and then recommencing the stapling, and optional cutting, procedure. This is very important in stapling and/or resecting the correct part of the diseased tissue and, in some applications, for resections where the cut must be an essentially non-linear cut.